Complex care needs suitable for Home Care

Complex care needs at home

Complex care can be carried out effectively at home for a number of health conditions, but it does have limitations. If you are looking into care options for a loved one with complex needs, you may be wondering if home care is suitable for your particular situation. Here, we are looking at which complex needs can be managed at home and which cannot, as well as how a home carer can provide support at home, and the questions you may wish to ask a potential carer to determine if they have the training and experience for the role.  

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about complex care at home, we can help. 

Can complex care take place at home? 

A number of complex needs can be well managed at home. While occasionally certain conditions will require treatment in hospital depending on the specific needs and length of time assistance will be required, most situations can be dealt with just as well in the person’s house as they can be elsewhere, enabling them to live well for longer in the comfort of their own home. Also, with complex care available at home and respite care services available for family caregivers, this type of care could be provided long-term if required. Some of the benefits of this include: 

• Similar health outcomes to that of hospital care – One study found those who received ‘hospital at home’ care had a similar outcome 6 months later as those who went to hospital, and another study found home care patients had a 26% lower risk for readmission to hospital. 
• Higher patient satisfaction – Studies found those who had care at home experienced greater levels of satisfaction than those who received care in hospital. 
• More personalised care – Those who need complex care may benefit from more specialised, bespoke care that acknowledges their home life and routine in order to improve the person’s health and wellbeing. 
• More independence – Home complex care enables people to maintain their independence and remain part of the decision-making on how they spend their time.  
• Reduced risk of infection – Complex care at home could result in a reduced risk of infection due to spending less time in hospital, and this can be especially helpful for those with a weakened immune system. 

You can read more about this in our guide to the benefits of complex care at home,

What sort of complex needs are suitable for home care?

Home care services can be life-changing for those with complex needs who require long-term or ongoing care, as it avoids them receiving this care in a hospital or nursing home. Some of the complex needs thought to be suitable for home care include:

• Recovery from surgery – Many people who are in recovery from a recent surgery may require additional help in order to maintain their usual routine, and this can be achieved at home rather than having the person stay in hospital. Home care can provide tailored help to assist people in recuperating in the comfort of their home, whether this means organising transportation, encouraging adherence to medication schedules, meal preparation, personal care or something else. 
• Medication management – Those with chronic health issues are likely to be taking medications in order to effectively manage symptoms, and home care can help those with complex needs to remain consistent with their medication. Onestudy found home-based care had a positive impact on adherence to medication schedules. 
• Wound care – Particularly in older adults, wounds may take longer to heal and therefore require more management than they would for younger people. Home care can help by keeping wounds clean, dressing them every day, and attending medical check-ins to ensure wounds are healing as they should be. You can read more in our guide to wound care management in older adults at home.
• Mobility support – Those with chronic health issues or disabilities may struggle to move around their home or elsewhere due to pain or discomfort. Home care can provide mobility support to help the person move around safely, encourage exercises to strengthen muscles (if appropriate), and facilitate the adjustment of the home environment to make moving around easier. 
• Neurological issues – Neurological issues can come with many symptoms that must be managed, and depending on their severity, many can be managed at home. Examples of conditions could include motor neurone disease (MND), muscular dystrophy (MD), Huntington’s disease, cerebral palsy, Parkinson’s, and epilepsy. 
• Stoma care – Conditions requiring a person to live with a stoma (an opening and device in the stomach that bypasses the digestive system) can be managed effectively at home by the individual (if they are able) or by a trained home carer. You can read more in our guide to living with a stoma for older adults.
• Catheter care – Many health conditions require a catheter to be inserted to drain the bladder in place of manual urination. Catheter care requires a lot of maintenance and cleaning, however this can be effectively done at home by the person themselves or a trained home carer. You can read more in our guide to living with a long term catheter for older adults.
• Feeding tubes – For those who cannot eat by themselves, either on a short-term or long-term basis, feeding tubes may be inserted to manage this. These could also be referred to as enteral nutrition or a PEG tube depending on the type inserted, and can be managed from home. You can read more in our guide to maintaining quality of life with a feeding tube.
• Ventilation support – This type of support helps with breathing difficulties, and although this will not be suitable for all health conditions (more serious breathing difficulties will need hospital intervention), in many cases this can be managed from home for long-term conditions. 
• Dementia conditions – Early and middle stage dementia is thought to be best managed at home, as this means the person can continue to remain in familiar surroundings with their own belongings and be visited by friends and family they know well. 
• Diabetes management – The management of diabetes can become difficult for older adults for a number of reasons (dexterity issues, mobility issues, and more) however with appropriate training this condition can be effectively managed at home. You can read more in our guide to diabetes in older adults.
• Physical disabilities and mobility limitations – Those with physical disabilities may occasionally require hospital treatments, but often there is no need for them to be moved to a care facility. Often home adaptations can be made, making their complex care manageable from home.

How can a home carer support complex needs?

Home carers play an important role in supporting those with complex needs by providing personalised assistance that can be tailored to the individual’s requirements and preferences. Home carers can offer help with daily personal care tasks such as bathing, getting dressed in the morning and preparing meals. If trained to do so, they can also carry out more specialist health care tasks such as administering medications, monitoring health conditions, and assisting with medical equipment as needed. Some of the most important benefits home carers bring to a complex care situation are emotional support and companionship, as these foster a sense of wellbeing for those who are in need of complex care and who may experience feelings of loneliness as a result. Home carers can also liaise with healthcare professionals, coordinate appointments and advocate for the person to ensure all complex needs are catered to.

How do you know if a carer has the training/experience to manage complex needs?

Truly effective complex care at home requires a trained, experienced and highly dedicated home carer who can take on the role and manage the person’s complex needs efficiently, and always with safety in mind. Assessing a carer’s training and experience in managing complex needs is incredibly important when enlisting the help of a complex carer. Some of the steps you may wish to carry out include:

1. Researching the most reputable care agencies and providers to ensure you are choosing the best person for the job. Don’t forget to check their ratings online and research the experiences others have had. You may find more information on searching for carers in our guide to how to choose and arrange home care services.
2. Check their certifications and qualifications in the relevant areas. Whatever complex needs you require help with – either for yourself or a loved one – you should ensure the person you are considering has the appropriate training and qualifications to provide the most up-to-date knowledge on the person’s complex needs. 
3. Ensure they have the experience needed for the job. While training and certifications are important, depending on the type of care you require it is often crucial to bring in experienced carers who will have come across many similar situations before and will know what to do in case of emergencies. 
4. Check their references and testimonials from previous clients or employers to gain insights into the carer’s competence and professionalism.
5. Ask questions to understand their knowledge, skills and abilities in handling specific scenarios related to the complex needs they are being hired to manage. Some of the questions you could ask include:

• “What experience do you have with this specific type of complex care work?” (For example, if they are being hired for stoma care, how much experience do they have managing a person’s stoma?)
• “Discuss an emergency situation you had to handle in a past care role”
• “What would you do if…?” (Here, you can include a specific possible scenario related to the type of complex care they are being hired to help with. For example, “What would you do if a person’s catheter showed signs of infection?”)

If you are looking to hire a home carer to assist with complex care needs for you or a loved one, you may wish to start by arranging a Care Needs Assessment, as this will give you more information about the type of care you might need and how to organise this through your local council. If you require a private carer for complex care, this is also an option. At Home Instead we provide home-based care for those with complex needs, and can cover a wide range of conditions and requirements, such as:

• Dementia care
• Parkinson’s care
• Care for neurological conditions 
• Palliative care
• Postoperative and recovery care
• Arthritis and mobility care
• Catheter management 
• Stoma management 
• Wound care
• Vital signs monitoring
• Diabetes monitoring 
• Non-invasive ventilation 
• Gastrostomy care and feeding support

If you believe you could benefit from home-based complex care and you would like to learn more about how this could work for your situation, our award-winning home care at Home Instead could offer you the bespoke, person-centred care you need. Reach out to our team to discuss your needs and allow us to create a personalised package to support you.